Medical aid 2017

Medical forum
Post Reply
User avatar
ChrisF
Top Web Wheeler
Top Web Wheeler
Posts: 8188
Joined: Thu Sep 17, 2009 2:56 pm
Town: inniedorp
Vehicle: Toy
Real Name: Chris

Medical aid 2017

Post by ChrisF »

JIP, that time of the year again .....

Medical aids are launching their 2017 packages and prices. Few new plans, but mostly just increased premiums and all too often reduced benefits ....

Okay so here are some of the plan increases, shown per principle dependant, then adult dependant and then the children - see attached


DISCOVERY :
Coastal Core - 15%
Coastal Saver - 7,8% (but note the reduction in savings amount)
Smart Plan - 10%
Executive plan - 12%
Comprehensive plans - 12%
Rest of the plans - 10%

Taking a wider look - the normal plans go up by 10%, the chronic (comprehensive) plans go up 12%, then a serious re-shuffle with the Coastal plans.


PROFMED :
varies between 9 and 13 % .... DO check up on the reduction in cancer cover !!

MOMENTUM :
12 to 15 % ....


The sad reality is that Discovery increases are NOT the highest in the trade ....
Attachments
medies verhoging 2017.pdf
(126.8 KiB) Downloaded 150 times
User avatar
pietpetoors
Moderator
Moderator
Posts: 10648
Joined: Thu May 17, 2007 9:12 pm
Town: Langebaan
Vehicle: 2.7 Hilux 4x4 DC
Real Name: Pieter
Club VHF Licence: X27
Contact:

Re: Medical aid 2017

Post by pietpetoors »

Only Dead Fish Go With The Flow!
Image
1999 Hilux 2.7i 4x4 Raider DC with 3.4 Prado V6. Rear diff-lock, Bull Bar and rock sliders, 31" Cooper ST Maxx, Snorkel, Alu-Canopy, VHF Motorolla radio, West Coast Rust, Mikem Suspension, Ball Joint Spacers in front and Mikem extended shackles at the rear, 25watt LED Spots
User avatar
ChrisF
Top Web Wheeler
Top Web Wheeler
Posts: 8188
Joined: Thu Sep 17, 2009 2:56 pm
Town: inniedorp
Vehicle: Toy
Real Name: Chris

Re: Medical aid 2017

Post by ChrisF »

Pieter the "problem" with the cheaper plans are that it becomes seriously locked into "networks" ....

You must get your medicine at a particular outlet ... okay, dependant on how close that outlet is, and their service levels it may be okay ..... Some the very cheap plans actually expect you to go sit in a line and get your chronic meds at the nearest state hospital !

Network hospitals are not that - at least you can do your homework upfront and decide .... I am on a plan that requires me to use network hospitals, with Panorama being on my network list. That is our prefered hospital in any case so no issue.

Some other plans expect you to use network GP's .... again one need to do your homework !! Some of these are no better than joining a long line at the local clinic, while others are actually pretty decent ....



Heaven forbid you need some expensive chronic meds, that fall outside the PMB list .... now you are looking at some serious premiums.

Ironically I have not even bothered to get my diabetic meds on chronic. Some R60 per month.
User avatar
Stef
Monster Truck
Monster Truck
Posts: 3125
Joined: Mon Jan 25, 2010 12:54 pm
Town: Pretoria
Vehicle: '98 LTD
Real Name: Stefan
Club VHF Licence: X107

Re: Medical aid 2017

Post by Stef »

This is why I got a hospital plan only; I pay the day to day stuff cash and claim everything from SARS....and the best of all is that their (Spectramed) cover in hospital is far better tham any med aid I've dealt with including these fancy "professionals only" med aids

Swambo's broken ankle cost R140k in total of which we had to pay the crutches and 2 specialist in theater X - Rays. They even paid the orthopedic pillows...go figure
User avatar
ChrisF
Top Web Wheeler
Top Web Wheeler
Posts: 8188
Joined: Thu Sep 17, 2009 2:56 pm
Town: inniedorp
Vehicle: Toy
Real Name: Chris

Re: Medical aid 2017

Post by ChrisF »

Stefan it is easy to forget why we need medical aid.

We stopped and helped at the scene of an accident. Two motorcycles collided. The one with medical aid was airlifted, and got the best treatment, and had a speedy recovery.

The other rider did not have medical aid .... lay there bleeding on the tar waiting for an ambulance .... finally got to a government hospital and waited a few more hours before being treated. Nearly passed away ! Took months to recover, well to get well enough to lead some sort of life. Had to go back for follow up opps to reach some sort of normality. His doctors told his family that if he had been airlifted and got speedy help he would have had a full recovery.

But we are in an era of "over-use" of medical aids, which keeps on escalating the premiums ....

Soon many will only be able to afford a hospital plan.
User avatar
ChrisF
Top Web Wheeler
Top Web Wheeler
Posts: 8188
Joined: Thu Sep 17, 2009 2:56 pm
Town: inniedorp
Vehicle: Toy
Real Name: Chris

Re: Medical aid 2017

Post by ChrisF »

As the days pass more and more medical aids launch their 2017 plans and rates.

In response to the various replies to this thread a bit of history of medical aids in SA.


The 80's were an easy era - if you worked for one of the many parastals you had easy access to medical aid. Is was typical of the era to have to choose between two plans : 80% or 100%. The 80% plan was cheaper and gave you full hospital cover but only 80% cover for "brille-pille-en-tanne" (all those out of hospital expenses). If you were one of the lucky few you could afford the 100% plan that covered everything in full.

Times moved on, and by the mid 80's the parastatels started shrinking ... or should I rather say private medical aids started gaining momentum.

Adrian Gore - https://www.discovery.co.za/portal/i...drian-gore-bio" onclick="window.open(this.href);return false; - will forever be remembered as the person that introduced SA to the world of "healthy living" (Vitality) and a medical aid with a savings plan.


By 1996 Discovery started growing aggresively. At the time their sales pitch was the savings plan .. and NOT the medical part of it, but the fact that you could save as much money as you wanted, interest at near prime, and tax free .... At the time some people were saving a few thousand rand a month in this savings plan - frankly no other investment scheme could compete. By 1998 or 1999 SARS picked up on this and got the Medical Aid Board to limit the savings amount to a maximum of 25% of the total premium. THIS caused some havoc !! Fact is that on a cheaper plan 25% simply does not put enough money aside for the out of hospital items ....

By now some other medical aids started playing catch-up .....

Now you had three broad options :
- 100% type plan that covered you in full - but getting way too expensive
- the Discovery type "savings plan" - where some of your money is put aside for the out of hospital expenses.
- Other medical aids introduced plans with "day-to-day" cover. The technical difference is that this amount does NOT transfer as with a savings plan, thus not limited by the 25% rule. In theory these plans offer more "total" cover that savings plans .... It typically offers a set max for glasses, a set max for dental, a set max for GP, etc etc ... Now IF you had the perfect combination of dental, optical, GP, etc visits then you would get more out of these plans .... Back on planet earth you have a bad optical year followed by a bad dental year ... and you never fully use the distributed cover.

Now Bonitas has gone as far as providing plans that give both "savings" AND "day-to-day" cover.


In the end it is near impossible to do a real side by side comparison of the various plans ...


Add in the various extras offered by so many of the medical aids, from logging your sports records, to movie tickets, etc etc the real issue becomes more and more clouded ....


Worth adding that the broker fee forms part of the medical premium. Thus no incentive for a broker to punt one plan over another .... well that is true for the medical part .... huge bonusses for signing new entrants to the various loyalty programmes ....


All said and done, when comparing similar cover for similar rates then the track record of the firm (their administration and payment records) is the only real decider.


This trade have totally evolved the last two decades. Going to be interesting to see what the next decade holds ....




PS - let me just say again - I am NOT a medical aid broker. Just somebody that have closely followed this industry for a few decades.

Why do I make these posts - It is scary how much money we spend on medical aid, yet very few people have a clue as to what plan they have or what cover they have ... and frankly most dont know where to start talking to their broker to figure out what they actually need.
User avatar
Stef
Monster Truck
Monster Truck
Posts: 3125
Joined: Mon Jan 25, 2010 12:54 pm
Town: Pretoria
Vehicle: '98 LTD
Real Name: Stefan
Club VHF Licence: X107

Re: Medical aid 2017

Post by Stef »

I hear you Chris; I fortunately have additional insurance for exactly that @ R99/month that includes airlifting.

We have been on Discovery, on the company med aid managed by Discovery, Old Mutual Oxygen...you name it. As soon as Discovery took it it over you had this so-called savings, which cost around R1500 a month but we had maybe R2000's worth of benefits p/a.One trip to the doctor and a prescription depleted your benefits for the entire year.... It is a rip-off!! In my opinion Discovery messed up the whole industry; most med aids are either partially owned or managed by Discovery.

It's not a case of "soon", most people already cannot afford it. I simply cannot see why I should pay for a so called 100% med aid and then still have to be out of pocket for doctors visits/hospital costs on top of that. I know 2 people in my circle of influence with R5k - R7k premiums sitting with med bills in excess of R20k that was not covered by the med aid

Then we're not even going down the road of generic medicine vs the real thing...been through this a few times on med aid where I had to go back to the doctor because a family member did not make a full recovery on what the fund is willing to pay for.

I believe that if companies stopped forcing their med aids down employees' throats we would have many more people on hospital plans only.

Getting a medical aid that suits your needs is like asking Multichoice for a DSTV package with only the 5 channels you really watch including Discovery and SuperSport....it's just not going to happen.
User avatar
ChrisF
Top Web Wheeler
Top Web Wheeler
Posts: 8188
Joined: Thu Sep 17, 2009 2:56 pm
Town: inniedorp
Vehicle: Toy
Real Name: Chris

Re: Medical aid 2017

Post by ChrisF »

Stef ja-nee ...

In 2007 I had a dental procedure that ended up costing me near 25k in 2008 ... obviously my savings were depleted by February because of this .... So I DO understand your post.

Right now I still have about R15k in my savings account, so in the long run it works for US. But people with small kids do struggle with these savings plans....

I work for a company that pays us cost-to-company and we can choose our own medical aid. 90% of us have plans with savings components. And we are spread over 5 different medical aid providers. Each with good points, AND each with its "limitations" ....



In the end these funds (medical aid companies) end up being very similar - with service delivery being the key differenciator.

As for the plans they offer .... NO WAY 10 different plans can accommodate all the needs of a few million different users. ONLY thing the end user can (and should) do is to speak to his medical aid broker and get the plan that best provides for his/her current situation/needs. And this really should be reviewed every couple of years as the plans change and our lives and needs change ...
Post Reply

Return to “Medical forum”